The purposes of the Clinical Oncology Program at Geisinger Medical Center are to 1) channel large numbers of patients with cancer into clinical research protocols for both cancer treatment and cancer control; 2) continue to stimulate ever-increasing quality of care for cancer patients, making full use of our large referral center; 3) provide a real stimulus to further efforts in cancer control, such as in screening, early detection, prevention, evaluation, ongoing care and rehabilitation. Aspects of the Geisinger System that favor continuation of our CCOP program include the large cancer patient population (1400 new cases/yr.), the excellent medical record system with unit patient charts, presence of all needed treatment specialist under one roof, who are full time, salaried staff, a well-working CCOP organization already in place, and a past record of successful accrual and superb data management. Our CCOP would remain multimodal, with the North Central Cancer Treatment Group as the primary research base, ECOG as a secondary affiliation, Radiation Therapy Oncology Group and a pediatric base, the Children's Cancer Study Group. This multimodal, multidisciplinary structure is a good reflection of our medical center in general, and is well suited to both our group practice and our multidisciplinary Cancer Center structure. Geisinger has always been a health care leader for this state, and is now leading the way to an expanded health care system, which includes a wide geographic spread of practice sites, different hospitals and group practices, and an HMO. The opportunity for enhanced cancer control efforts with a system like this will be given further incentive through the CCOP, with its NCI-mandated shift of emphasis to include control research. This application will demonstrate Geisinger's long-standing interest in cancer control, and cancer control research efforts. The expanding Geisinger System will give us a larger arena in which to develop and demonstrate our competence in this profoundly important effort. We welcome the challenge to move ahead and accomplish even more under the new CCOP program. We are excited to be newly associated with a cooperative group, the NCCTG, that is emerging as a leader in the cancer control research field. Relevant protocols with good science that are well suited to a rural group practice was the major attraction the NCCTG offered, and we are in a position to capitalize on it fully.